Inverclyde Dementia Care Co-ordination Programme: Learning and innovations in Inverclyde during the rst wave of the COVID-19 pandemic

This snapshot shares experiences from Inverclyde Health and Social Care Partnership (HSCP) during the rst wave of the COVID-19 pandemic. This includes how Health and Social Care services responded and how staff wellbeing was supported. We also highlight the role of technology, the experiences of people living with dementia and their carers, and how the third sector and local community supported the COVID-19 response. Background

Inverclyde is the Dementia Care Co-ordination Programme implementation site, aiming to improve care co-ordination for people with dementia and their carers.

Inverclyde was signicantly affected during the rst wave of the pandemic. Challenges for the delivery of Health, Social Care, Third Sector and Community Services required change in how services and supports operated. This also led to the suspension of the Dementia Care Co- ordination programme for six months in March 2020.

When the programme was reactivated we consulted with our stakeholders again, and during this time some highlighted their experiences during the pandemic and how the local community had responded. They shared rich examples of the lessons learned and local innovations and, while this is not related to the Dementia Care Co-ordination Programme, there was agreement to collate and share a snapshot of their experiences within Inverclyde that many other areas across Scotland will recognise. Examples provided are how people in Inverclyde were supported and includes people with dementia, people with learning disabilities and people living in care homes. The examples outlined here focus on the delivery of Health and Social Care Services, staff experiences and For more information on Dementia Care Co-ordination wellbeing, the role of technology, the experiences of people with dementia and their carers, and the visit the programme website. role of the third sector and local community. Delivering Services during COVID-19

Health and social care services adapted their normal operating procedures in response to the rst wave of the pandemic, prioritising services and support for those with critical and substantial need. Non-essential face to face services and support were suspended or had to be adapted because of lockdown restrictions. This created challenges such as closure of day care and respite services, increased waiting times for non-essential services and visiting restrictions in care homes and inpatient services, separating families. Here is a snapshot of how some services addressed these challenges.

Learning Disability Services Dementia Services

Occupational Therapists provided home activity packs in easy-read format to help Put steps into place to safely re-establish the Post Diagnostic Support (PDS) people stay active and well at home. Service. Remote IT access from home was arranged to facilitate continued The Fitzgerald Team provided alternative services while the day centre was telephone or online interventions instead of usual face to face interventions in the closed. They co-ordinated hot meal delivery and some home care services. service user’s home. Small dedicated teams provided support for individuals with advanced dementia Provided written information to people living with dementia and their carers who in supported living settings. This reduced the risk of COVID-19 exposure, provided were on the waiting list for the PDS service, regarding available supports and consistency of care provider and the service users remained calm and happy. services during the pandemic. Developed easy-read guides explaining COVID-19 lockdown restrictions. Inverclyde’s Alzheimer Scotland Resource Centre continued to provide support for Used technology such as smartphones and tablets to keep in touch with those people living with dementia and their carers by telephone and online platforms. who did not have support at home. Nursing and support staff continued to carry out memory assessments. The Older People’s Mental Health team carried out keep in touch telephone calls Glenfield and Bagatelle Care Homes with their patients.

Introduced headphones and microphones to improve communication between Orchard View residents and their visitors who had to wear PPE and socially distance. Created a new physiotherapy department to help residents with movement, as Ensured carer and family involvement in ward rounds using virtual technology. access to communal spaces was restricted. This new department worked Used virtual technology on tablets to ensure person centred visiting continued. alongside the existing activities department and all activities had a physical Used Stimulated Presence Therapy, which involves recording a personalised video focus, for example, exercising in the corridors, dancing and doing housework. from family members and uploading these onto a tablet. Staff then played the This whole home approach involves all staff, with housekeepers encouraging videos when the person living with dementia was distressed or agitated. residents to help with housework, catering staff encouraging residents to walk to the trolley and pick their own cake, and nurses encouraging residents to walk to Further information on the response to COVID-19 within Inverclyde is the medicine trolley. A focus on movement within everyday activities was available on the Inverclyde HSCP website. resulted in good outcomes for the residents. Workplace Wellbeing Matters: A Wellbeing & Resilience Delivery Plan for Inverclyde’s Health & Social Care Workforce

Inverclyde recognises that staff are their biggest asset and that health and social care services have been impacted by the pandemic. In order to support staff, staff engagement and consultation was undertaken to identify what was important to them based on their experiences during the pandemic. This information was used to inform the Wellbeing and Resilience Delivery Plan, developed to support and sustain an effective, resilient, and valued health and social care workforce. Inverclyde Staff Wellbeing Task Group A task group was established to oversee and implement national and local staff wellbeing work. Actions from the task group included: 191 Care at Home staff received wellbeing telephone calls and were signposted to support. A staff wellbeing and agile working survey was carried out by a separate team. 54 members of staff provided feedback through focus groups and online questionnaires. Local Staff Wellbeing Champions were identied to link with National and GGC wellbeing groups.

A number of improvement activities have been identied and are summarised in the Wellbeing and Resilience Delivery Plan Driver Diagram and within the Inverclyde Wellbeing Delivery Plan.

Across Inverclyde we will deliver on integrated and collaborative Driver Diagram for Workplace Wellbeing Matters: approaches to support and sustain effective, resilient, and a valued health Inverclyde’s Wellbeing and Resilience Delivery Plan and social care workforce.

Overarching aim of the Workplace Wellbeing Matters: Inverclyde’s Wellbeing and Resilience Delivery Plan The Role of Technology

A common theme when looking at lessons learned and innovation during the rst wave of the pandemic is the important role of technology. Examples include delivering services and support through telephone and online platforms, keeping staff and service users connected, enhancing communication, facilitating exible working and remote access and supporting independent living. Here are some examples where technology was used.

Telephone Support groups and services

Keep-in-touch calls for service users, people who were Organisations are continuing to provide community isolated or shielding, as well as local wellbeing calls to support using technology. For example Alzheimer staff. Online Platforms Scotland in Inverclyde arranged the following via online platforms: “Although IT is important, the role of telephones Near Me online platform Dementia reference group was also important, as everyone knows how used to deliver services carer support groups to use them.” and support. weekly football memory discussions, and (Carer, Dementia Reference Group) This required service users weekly friendship groups. & staff to have access to IT equipment and knowledge of how to use this.

Staff remote access and virtual meetings Technology enabled support and communication aids

Staff across Health, Social Care, third sector and These were used to support communication with family community services within Inverclyde had to change members in care homes and inpatient services. how they worked. Those who had appropriate IT kit were able to work from home and access meetings via Using Technology Enabled Care promoted online platforms. This worked well when staff independence and exercise. had the right IT equipment and knew how to use it. Inverclyde Dementia Reference Group: experiences during a pandemic

The Inverclyde Dementia reference group is jointly co-ordinated and facilitated by Your Voice and Alzheimer Scotland. The group is for people living with dementia and their carers. It is a place where stories, experiences, ideas and coping strategies are shared. It was agreed that the Dementia reference group would oversee and inform the Inverclyde Dementia Care Co-ordination Programme. Here is a summary of the group’s experiences during the initial lockdown: Loneliness Loneliness was discussed due to loss of social interaction with others, in particular when community support was discontinued. Having to stay at home was dicult for the person living with dementia and they felt lost a lot of the time.

It’s been a very long 20 weeks or so. I suppose the biggest factor was not having the social contact that we were used to…we missed the groups and our church, we really were cut off from everything and this denitely made the whole experience a lot less pleasant.”

“It has been an inconvenience, I felt lonely with not being able to go out, and no-one allowed to come in. For the rst 6 weeks I had no internet and no TV as no one was able to come out to x it…. I coped okay though; and was eventually fortunate enough to be able to speak with my son every day using my iPad”. What helped

“In general, it was lonely during the peak period…there was no pleasure, no enjoyment… it became The availability of IT was described as a ‘life saver’, allowing connection very stressful at times. to family and friends. Although IT was seen as important, the role of telephones was also important and it was acknowledged that everyone knows how to use them. A challenge was that some did not know how to Caring responsibilities use IT systems. Because of their caring commitments and lack of social interaction with others, carers expressed that The support provided by Alzheimer Scotland, their neighbours and the they had no ‘me time’. wider community were valued by the group.

Due to the lockdown restrictions one carer did not get help from others to carry out their daily chores. It’s brought the community closer together.” They described this like being on a ‘hamster wheel’ and were exhausted by the end of the day. There were also concerns about what would happen to the person they cared for if the carer became unwell, “People have generally been nicer to one another…there really has in particular if the reason was related to COVID-19, and who would look after the person they cared for. been a good community spirit. Third Sector and Community Response

The role of third sector organisations and the local community was signicant during the initial period of lockdown. The Inverclyde Community Action Response Group was set up by local campaigners. The group included Belville Community Garden, Branchton Community Centre, CVS, Your Voice, the Trust, Inverkip Hub, Compassionate Inverclyde, Mind Mosaic Counselling and Therapy and local community volunteers. Partners came together to assist older and vulnerable people who were shielding or were unable to leave home during the pandemic. The group also arranged support for frontline key workers through a dedicated helpline run by counselling experts Mind Mosaic.

A snapshot of the group’s achievements:

1,070 prescriptions were collected 27,232 meals were distributed to those who needed them 4,059 food boxes were distributed to those who needed them 8,683 keep-in-touch calls were made 67 shielding toiletry bags were distributed 95 'lifeline grocery' deliveries for those who were self-isolating

37,224 volunteer hours across 5 months of COVID-19 support – 24.2 years of effort

Some of the partners involved in the response Other third sector support

Third sector services also had to adapt their services and support during the pandemic. The following are examples of what was achieved.

Inverclyde Carers Centre is a dedicated service that identies and Your Voice Community Care Forum brings together a supports unpaid Carers. During the pandemic they: collective voice of voluntary, community groups, service users and carers to be heard in the planning and provision Continued to stay in touch and provide support and services for of community care services in Inverclyde. During the local carers either online, via telephone or text. pandemic they: Introduced a befriending service where carers were trained to support other carers Provided support & isolation calls from their Community Connectors and share their own experiences Co-hosted the Dementia Reference Group with Alzheimer Scotland, obtaining feedback Supplied PPE for carers on the group’s experiences during lockdown. This was shared locally and nationally, Provided funding for the provision of alternative short breaks, and are continuing to informing COVID-19 recovery planning. do so, allowing carers to have sucient and regular periods away from their caring Provided online activities, quizzes and support groups. routines or responsibilities. Examples included supplying walking boots, tablets, Collated feedback from 126 people in the local community about their experiences tness equipment and garden equipment. during lockdown.

Alzheimer Scotland is a national dementia charity. They aim CVS Inverclyde has a key role in co-ordinating the community and to ensure no one faces dementia alone and provide support third sector’s response to the pandemic. This is in partnership with and information for people with dementia, their carers and Inverclyde’s Third Sector, the HSCP & Council, Housing Associations, families. With the Inverclyde Dementia Resource Centre, Scottish Government and the local community. during the pandemic they: During the pandemic they: Provided regular telephone & video call support Supported people across Inverclyde who were shielding Facilitated support groups & activities online to keep people connected. Created a helpline for residents in need during the pandemic, in partnership with Provided information and advice about dementia diagnosis through their Local Inverclyde Council. Dementia Advisor. Recruited 319 volunteers since 18 March 2020 Co-hosted the Dementia Reference Group with Your Voice and collated feedback Arranged for Inverclyde’s Community Link Workers to help the local community through on their experiences during lockdown. the use of technology such as phone calls, video calls and text messaging. Successfully applied for iPads through the Connecting Scotland Programme, distributed to those who required them. Compassionate Inverclyde

The Compassionate Inverclyde project enables ordinary people to help ordinary people, guided by the community values of being kind, helpful and neighbourly. The project aims to help transform attitudes and everyday practices around loneliness, social isolation, death and bereavement across Inverclyde.

Find more information on the Compassionate Inverclyde - Ardgowan Hospice website. Ordinary people helping ordinary people Between 17 March and 31 July 2020 Compassionate Inverclyde supplied items to patients and staff within Inverclyde Royal Compassionate Inverclyde Hospital and the wider Inverclyde community. All items were donated by Inverclyde residents and businesses.

Some of the items donated

197 327 183 25 895 119 back home boxes isolation boxes face masks pairs of socks pyjamas blankets

238 25 419 596 58 675 Greenock bags of wool packets of biscuits toiletry items packs of sweets bottles of juice Telegraphs